Nokea
Three hours postpartum, a primiparous patient's fundus is firm and midline. On perineal inspection by Nurse Kayla, she observes a small constant trickle of blood. What will thee nurse suspect for the patient to have?
- A. Uterine inversion
- B. Retained placenta
- C. Perineal lacerations
- D. Bladder distention
Correct Answer: B
Rationale: In this scenario, the firm and midline fundus at three hours postpartum indicates that the uterus is contracting well. The presence of a small constant trickle of blood on perineal inspection suggests ongoing bleeding. This combination of findings is concerning for retained placenta, where a portion of the placenta remains attached to the uterine wall and prevents proper contraction and closure of the blood vessels at the placental site. Retained placenta can lead to postpartum hemorrhage and requires prompt evaluation and intervention to prevent complications. Nurse Kayla should escalate this finding to the healthcare provider for further assessment and management.
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Upon clinical assessment, the nurse observes that the OUTSTANDING manifestation of the patient is ______.
- A. weight gain
- B. obesity
- C. emaciation
- D. edema
Correct Answer: D
Rationale: Upon clinical assessment, the nurse observes that the outstanding manifestation of the patient is edema. Edema is characterized by the accumulation of excess fluid in the body's tissues, leading to swelling. Edema can be a sign of various health conditions, such as heart failure, kidney disease, liver disease, or injury. It is crucial to identify and address the underlying cause of edema promptly to prevent complications and provide appropriate treatment for the patient.
A patient with a history of heart failure is prescribed a beta-blocker. Which assessment finding indicates a therapeutic effect of beta-blocker therapy?
- A. Decreased heart rate
- B. Increased blood pressure
- C. Elevated respiratory rate
- D. Worsening dyspnea Pharmacology
Correct Answer: A
Rationale: Beta-blockers are medications commonly used in the management of heart failure. One of the therapeutic effects of beta-blockers is to decrease the heart rate. By blocking the action of adrenaline on the heart, beta-blockers help to slow down the heart rate, reduce the workload on the heart, and improve overall heart function. In patients with heart failure, a decreased heart rate is a favorable outcome as it can help improve cardiac output and reduce symptoms of heart failure such as fatigue and shortness of breath. Monitoring the heart rate is an important assessment parameter to evaluate the effectiveness of beta-blocker therapy in patients with heart failure. Therefore, a decreased heart rate would indicate a therapeutic effect of beta-blocker therapy in this patient.
A patient presents with a painless thyroid nodule and hoarseness of voice. Fine-needle aspiration biopsy reveals papillary thyroid carcinoma. Which endocrine disorder is most likely responsible for these symptoms?
- A. Hashimoto's thyroiditis
- B. Graves' disease
- C. Diabetes mellitus
- D. Thyroid cancer
Correct Answer: D
Rationale: In this scenario, the patient's presentation of a painless thyroid nodule and hoarseness of voice is consistent with papillary thyroid carcinoma, a type of thyroid cancer. While Hashimoto's thyroiditis and Graves' disease are autoimmune thyroid conditions that can lead to thyroid nodules, they typically do not present with hoarseness of voice. Diabetes mellitus does not directly cause these symptoms. Thyroid cancer, particularly papillary thyroid carcinoma, is the most likely cause based on the patient's clinical presentation and the biopsy results.
In case of poisoning, the nurse is aware that the main goals in poisoning are to ________. I. inactivate the poison II. administer the specific antidote III. induce the patient to vomit IV. support vital organ functions
- A. I, II, and IV
- B. I, II, and IV
- C. I, II, and III
- D. II, III, and IV
Correct Answer: A
Rationale: In cases of poisoning, the main goals are to inactivate the poison to prevent further harm, administer the specific antidote if available to counteract the effects of the poison, and support vital organ functions to help the patient recover. Inducing the patient to vomit (III) is not always recommended as it can potentially cause more harm, especially if the ingested substance is corrosive. Therefore, the most appropriate goals in poisoning are to inactivate the poison, administer the specific antidote, and support vital organ functions.
A patient with a history of chronic kidney disease is prescribed a low-protein diet. Which dietary choice indicates understanding of the prescribed diet?
- A. Grilled salmon
- B. Lentil soup
- C. Beef stew
- D. Chicken Caesar salad
Correct Answer: D
Rationale: A patient with chronic kidney disease prescribed a low-protein diet should avoid high-protein foods like grilled salmon, lentil soup, and beef stew. Chicken Caesar salad, on the other hand, typically contains a smaller amount of protein compared to the other options. This choice indicates an understanding of the need to limit protein intake while still enjoying a balanced meal. However, it is important to note that the quantity and portion sizes of high-protein ingredients in the salad should also be moderate to comply with a low-protein diet.